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  • The mechanism of formation of pulmonary arteriovenous malformations associated with the classic Glenn shunt (superior cavopulmonary anastomosis)

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The mechanism of formation of pulmonary arteriovenous malformations associated with the classic Glenn shunt (superior cavopulmonary anastomosis)
  1. H Ashrafian,
  2. L Swan
  1. Adult Congenital Heart Disease Programme, Royal Brompton Hospital, London, UK
  1. Correspondence to:
    Houman Ashrafian, c/o Dr L Swan, Adult Congenital Heart Disease Programme, Royal Brompton Hospital, London, SW3 6NP, UK;
    ashrafian{at}hotmail.com

https://doi.org/10.1136/heart.88.6.639

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    Anastomosis of the superior vena cava to the right pulmonary artery (classic Glenn shunt), although initially a successful procedure, is complicated by the development of troublesome diffuse microvascular and potentially lethal macrovascular pulmonary arteriovenous malformations (PAVMS) in up to 25% of cases. The pathogenesis of PAVMS is unclear but has been tentatively attributed to either the absence of pulsatile pulmonary blood flow or the absence of hepatoenteric effluent in the right lung.1 Evidence favours the latter suggestion. Firstly, other forms of cavopulmonary connection result in loss …

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